{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,7]],"date-time":"2026-03-07T13:20:22Z","timestamp":1772889622429,"version":"3.50.1"},"reference-count":23,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2023,8,23]],"date-time":"2023-08-23T00:00:00Z","timestamp":1692748800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Clinical Otolaryngology"],"published-print":{"date-parts":[[2023,11]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Objectives<\/jats:title><jats:p>The aim of this study was to assess the efficacy of a new emergency department (ED) intervention for the management of non\u2010traumatic, anterior epistaxis in adult patients, aiming to reduce epistaxis admissions.<\/jats:p><\/jats:sec><jats:sec><jats:title>Design<\/jats:title><jats:p>A new epistaxis pathway was introduced for use by ED practitioners. This was disseminated in ED through an educational campaign by the ear, nose and throat team. A tranexamic acid (500\u2009mg\/5\u2009mL)\u2010soaked NasoPore\u00ae packing step was introduced for epistaxis which did not terminate following 10\u2009min of simple first aid. The pathway was utilised for adult patients presenting with non\u2010traumatic, anterior epistaxis. Pre\u2010 and post\u2010implementation periods were defined, and all adults attending ED with non\u2010traumatic, anterior epistaxis were included. Pre\u2010 and post\u2010implementation epistaxis treatment interventions, admission rates and re\u2010attendance rates were recorded by retrospective audit and compared.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>In the post\u2010implementation group, epistaxis admissions were 51.7% (<jats:italic>p<\/jats:italic>\u2009&lt;\u2009.05) lower than in the pre\u2010implementation group, as a proportion of the total number attending ED with epistaxis during these periods.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>The significant reduction in epistaxis admissions demonstrates that this ED intervention is beneficial for patient outcomes.<\/jats:p><\/jats:sec>","DOI":"10.1111\/coa.14093","type":"journal-article","created":{"date-parts":[[2023,8,24]],"date-time":"2023-08-24T06:44:32Z","timestamp":1692859472000},"page":"909-914","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Use of tranexamic acid\u2010soaked <scp>NasoPore<\/scp>\u00ae in the emergency department, to reduce epistaxis admissions"],"prefix":"10.1111","volume":"48","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-2398-7648","authenticated-orcid":false,"given":"Eleanor","family":"Rosario","sequence":"first","affiliation":[{"name":"Department of Otolaryngology University College London Hospitals  UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ekta","family":"Sharma","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology University College London Hospitals  UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ankit","family":"Patel","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology University College London Hospitals  UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Gabrielle","family":"Guvensen","sequence":"additional","affiliation":[{"name":"University College London Medical School  UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Rizal","family":"Ashroff","sequence":"additional","affiliation":[{"name":"Accident &amp; Emergency Department University College London Hospitals  UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Fiona","family":"McClenaghan","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology University College London Hospitals  UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4276-0628","authenticated-orcid":false,"given":"Ahmad","family":"Hariri","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology University College London Hospitals  UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6168-095X","authenticated-orcid":false,"given":"Jonathan","family":"Joseph","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology University College London Hospitals  UK"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2023,8,23]]},"reference":[{"key":"e_1_2_12_2_1","doi-asserted-by":"publisher","DOI":"10.1111\/coa.13716"},{"key":"e_1_2_12_3_1","doi-asserted-by":"publisher","DOI":"10.1136\/emj.2004.015842"},{"key":"e_1_2_12_4_1","doi-asserted-by":"publisher","DOI":"10.1017\/S0022215117002018"},{"key":"e_1_2_12_5_1","unstructured":"National Institute for Health and Care Excellence.Clinical knowledge summaries: acute epistaxis.2022Available from:https:\/\/cks.nice.org.uk\/topics\/epistaxis-nosebleeds\/management\/acute-epistaxis\/"},{"key":"e_1_2_12_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.otohns.2006.10.035"},{"key":"e_1_2_12_7_1","doi-asserted-by":"publisher","DOI":"10.1111\/coa.13555"},{"key":"e_1_2_12_8_1","unstructured":"ENT UK.COVID\u201019 epistaxis management.2020Available from:http:\/\/orlcg.me\/files\/documents\/0a48afd1-f0a7-4089-9097-c3ac1037b472.pdf"},{"key":"e_1_2_12_9_1","doi-asserted-by":"publisher","DOI":"10.1017\/S0022215117002055"},{"key":"e_1_2_12_10_1","doi-asserted-by":"publisher","DOI":"10.1177\/1060028018820625"},{"issue":"12","key":"e_1_2_12_11_1","article-title":"Tranexamic acid for patients with nasal haemorrhage (epistaxis)","volume":"2018","author":"Joseph J","year":"2018","journal-title":"Cochrane Database Syst Rev"},{"key":"e_1_2_12_12_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.amjoto.2019.04.012"},{"key":"e_1_2_12_13_1","doi-asserted-by":"publisher","DOI":"10.1308\/003588412X13373405386691"},{"key":"e_1_2_12_14_1","doi-asserted-by":"publisher","DOI":"10.1002\/lary.25374"},{"key":"e_1_2_12_15_1","doi-asserted-by":"publisher","DOI":"10.1186\/1741-7015-9-1"},{"key":"e_1_2_12_16_1","doi-asserted-by":"publisher","DOI":"10.1097\/XEB.0000000000000115"},{"key":"e_1_2_12_17_1","doi-asserted-by":"publisher","DOI":"10.1002\/gps.5687"},{"key":"e_1_2_12_18_1","doi-asserted-by":"publisher","DOI":"10.1080\/20477724.2019.1632070"},{"key":"e_1_2_12_19_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.n70"},{"key":"e_1_2_12_20_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0093959"},{"key":"e_1_2_12_21_1","doi-asserted-by":"publisher","DOI":"10.1017\/S0022215111002179"},{"key":"e_1_2_12_22_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12873-021-00529-w"},{"key":"e_1_2_12_23_1","doi-asserted-by":"publisher","DOI":"10.1377\/hlthaff.2020.02464"},{"key":"e_1_2_12_24_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0248995"}],"container-title":["Clinical Otolaryngology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/coa.14093","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,10,12]],"date-time":"2023-10-12T04:28:04Z","timestamp":1697084884000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/coa.14093"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,8,23]]},"references-count":23,"journal-issue":{"issue":"6","published-print":{"date-parts":[[2023,11]]}},"alternative-id":["10.1111\/coa.14093"],"URL":"https:\/\/doi.org\/10.1111\/coa.14093","archive":["Portico"],"relation":{},"ISSN":["1749-4478","1749-4486"],"issn-type":[{"value":"1749-4478","type":"print"},{"value":"1749-4486","type":"electronic"}],"subject":[],"published":{"date-parts":[[2023,8,23]]},"assertion":[{"value":"2022-11-15","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2023-08-03","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2023-08-23","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}